National Provider Identifier
Kevin B. Wynne, O.D.
Kevin B. Wynne, O.D. is listed in the NPPES registry with a primary specialty of Eyewear Supplier in Rochester, NY and a listed phone number of (585) 654-9200.
Profile Overview
- NPI
- 1275658924
- Provider Type
- Organization
- Primary Specialty
- Eyewear Supplier
- Enumeration Date
- March 20, 2007
- Last Updated
- August 22, 2020
Practice Location
- 1524 Culver RD
- Rochester, NY 14609-4241
Phone: (585) 654-9200
Specialties
- Eyewear Supplier (332H00000X)
Full Record
- NPI
- 1275658924
- Entity Type
- Organization
- EIN
- <UNAVAIL>
- Organization Name
- Kevin B. Wynne, O.D.
- Mailing Street Address
- 1524 Culver RD
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14609-4241
- Mailing Country
- US
- Mailing Phone
- (585) 654-9200
- Practice Street Address
- 1524 Culver RD
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14609-4241
- Practice Country
- US
- Practice Phone
- (585) 654-9200
- Enumeration Date
- March 20, 2007
- Last Updated
- August 22, 2020
- Authorized Official Last Name
- Wynne
- Authorized Official First Name
- Kevin
- Authorized Official Middle Name
- Bradley
- Authorized Official Title
- Optometrist
- Authorized Official Phone
- (585) 654-9200
- Organization Subpart
- No
- Authorized Official Name Prefix Text
- Dr.
- Authorized Official Credential Text
- O.D.
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Eyewear Supplier (332H00000X)
- Other Identifiers
- G0187194590 (NY, Blue Choice Group Number)